What do we tell the Children?

Dr. Katie Koehler Assistant Director of Bereavement Services

Formerly known as The Child Bereavement Trust

A simple childThat lightly draws its breathAnd feels its life in every limbWhat should it know of death?

William Wordsworth, We are seven

The Elephant in the Room

There’s an elephant in the room.

We all know it’s there.We are thinking about the

elephant as we talk together.

It is constantly in our minds.

For, you see, it is a very large elephant.

It has hurt us all.But we don’t talk about the

elephant in the room.

Terry Kettering

Families in grief

At a time when partners need each other most and children need their parents, they are often unable to be emotionally available to each other because they are consumed with their own grief.

Factors affecting the grieving process

Relationship with person who died

‘Recovery’ environment

Circumstances of death/dying

The child, personality,background

Tasks of Mourning

• To accept the reality of the loss• To experience the pain of grief• To adjust to an environment in which the person who

has died is missing• To emotionally relocate the person and move on with life

J William Worden

Everyday Life Experience

Loss-oriented

Grief work

Intrusion of grief

Breaking bonds/ties

Denial/avoidance of restoration

changes

Restoration-oriented

Attending to life changes

Doing new things

Distraction from grief

Denial/avoidance of grief

New roles/identity/ relationship

A Dual Process Model of Coping with Bereavement

Stroebe & Schut (1999)

In working with grieving families, we all bring our own

• hurts and losses• feelings about loss by death• desire to care for others• ability to reach out and involve ourselves• inability, when overpowered by the horror or

tragedy of a child’s death and our own sadness“A Child Dies; a Portrait of Family Grief.” Joan Hagan Arnold & Penelope Buschman Gemma 1983. 1983.

Effects of bereavement on children

• Physical health• Cognitive responses• Behavioural responses• Emotional responses

Indirect impact

• Closed communication that can be detrimental (Holliday 2002) .

• The nature of the sibling relationship (Hindmarch 2000)

• Role of the surviving sibling is affected (Holliday 2002)

• Parental overprotection can affect self esteem and independence (Gibbons 1992)

• (Holliday 2002)

Secondary losses

• Loss of security• Loss of attention• Loss of normality• Loss of confidence

Children’s experience of bereavement

• Loss of the living as well as the dead

• Adults can seek support, children are left with what is given to them

• Act out feelings rather than speak them

• Revisit their grief at each life stage

What can we do to help?

• Understanding, love and sensitivity• To be involved• Honesty• Information• Opportunity to express feelings• To revisit their grief as they become older

Children can only cope with what they knowWolfelt 1996

Resilience

• Is promoted by:– Temperament– Scholastic competence– Self-esteem– Supportive relationships – Communication – Ability to share– Familial emotional support

Family Support

• Bereaved children are protected by their relationships with surviving family members (Harrington & Harrison 1999)

• Families with higher cohesion, active/recreational orientation and moral/religious emphasis had children with fewer behaviour problems post bereavement (Davies 1988)

• Be honest 

• As soon as possible: or may undermine confidence in adults 

• Begin talking to the child about what he/she experienced or noticed

• Use the adult reality

How do I talk to a child about death?

• Let him/her ask questions as often as he/she wants

• Answer questions accurately

• Watch out for the child’s tendency to blame him/herself

• Give clear message it was not his/her fault

• Encourage child to remember and talk about the person who has died

How do I talk to a child about death?

www.childbereavement.org.uk

The Guiding Principles

• Young people need, want and deserve honesty, truth and choices.

• You can not “fix it”.

• Grief is a normal, healthy, response to lossBased on an article written by Donna Schuurman, The Dougy Centre

Award-winning publications and resources

Website www.childbereavement.org.uk

Families Discussion Forum

Support and Information Line: 01494 568900Email: enquiries@childbereavement.org.uk

www.childbereavement.org.uk